胰岛素泵强化治疗对胃癌合并2型糖尿病患者的影响

Influence of Intensive Insulin Pump Therapy on Gastric Cancer Patients with Type 2 Diabetes Mellitus

目的:探讨胰岛素泵强化治疗胃癌合并2型糖尿病对术后血糖水平、并发症的影响。方法:病例源于2019年1月-2020年6月武穴市中医医院收治的胃癌合并2型糖尿病患者共100例,以简单随机化法分为两组(各50例)。两组均接受胃癌根治术治疗。观察组围手术期采取胰岛素泵强化治疗,对照组围手术期采取胰岛素常规治疗,对两组空腹血糖水平、低血糖发生率、胰岛素抵抗、血糖达标时间、并发症及术后恢复情况进行比较。结果:两组手术前FPG水平相比,差异无统计学意义(P>0.05);两组手术结束时FPG水平均明显上升,差异有统计学意义(P<0.05),在术后次日、出院日FPG水平均呈降低趋势(P<0.05),观察组术后各时间段FPG水平低于对照组,差异有统计学意义(P<0.05);两组术前FINS、lnHOMA-IR水平比较,差异无统计学意义(P>0.05),观察组手术前后FINS、lnHOMA-IR水平比较,差异无统计学意义(P>0.05),对照组术后FINS、lnHOMA-IR水平较术前上升,观察组术后FINS、lnHOMA-IR水平低于对照组,差异有统计学意义(P<0.05);观察组低血糖发生率(10.00%)低于对照组(28.00%),血糖达标时间早于对照组,差异有统计学意义(P<0.05);观察组切口感染、酮症酸中毒、呼吸道感染发生率(6.00%)低于对照组(24.00%),差异有统计学意义(P<0.05);观察组切口愈合时间、住院时间短于对照组,差异有统计学意义(P<0.05)。结论:针对胃癌合并2型糖尿病采取胰岛素泵强化治疗效果显著,可有效控制血糖水平,降低低血糖发生率,改善患者胰岛素抵抗,减少术后并发症,对术后机体康复具有促进作用。

Objective:To explore the influence of intensive insulin pump therapy for gastric cancer combined with type 2 diabetes.Method:The cases originated from 100 patients with gastric cancer and type 2 diabetes who were admitted to Wuxue Traditional Chinese Medicine Hospital from January 2019 to June 2020.They were divided into 2 groups(50 cases in each)by simple randomization method.Both groups received radical gastrectomy for gastric cancer.The observation group was treated with intensive insulin pump treatment during the perioperative period.The control group received insulin routine treatment during the perioperative period.The fasting blood glucose level,hypoglycemia incidence,insulin resistance,time to blood glucose standard,complications and postoperative recovery were compared between the two groups.Result:There was no significant difference in the FPG levels between the two groups before surgery(P>0.05);the FPG levels of the two groups increased significantly at the end of the surgery,the differences were statistically significant(P<0.05),and the FPG levels showed a decreasing trend on the day after surgery and the day of discharge(P<0.05),the FPG levels postoperative time periods of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences in FINS and lnHOMA-IR levels between the two groups before operation(P>0.05),there were no significant differences in FINS,lnHOMA-IR levels before and after operation in the observation group(P>0.05),the FINS and lnHOMA-IR levels after operation of the control group increased compared those before treatment,and the levels of FINS,lnHOMA-IR after operation in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of hypoglycemia in the observation group(10.00%)was lower than the control group(28.00%),and the blood glucose reaching the standard time was earlier than the control group,the differences were statistically significant(P<0.05);the incidence of incision infection,ketoacidosis,and respiratory infection in the observation group(6.00%)was lower than the control group(24.00%),the difference was statistically significant(P<0.05);the incision healing time and hospital stay in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Intensive insulin pump therapy for gastric cancer combined with type 2 diabetes has a significant effect.It can effectively control blood glucose levels,reduce the incidence of hypoglycemia,improve patients’insulin resistance,reduce postoperative complications,and promote postoperative body recovery.